Morgan Frazier, a 7-year-old from Charlestown, IN, was born with spastic quadriplegia cerebral palsy, a neurologic disorder that affects the brain's ability to control movement of all four limbs. Since infancy, she has attended physical therapy (PT) sessions that include stretching and assisted walking at least three days per week in order to improve her muscle spasticity and range of motion. When she was 2, her family and therapists called it play time.
Five years later, Morgan has come to view that "play time" with less enthusiasm, says Morgan's mother, Andrea. She has, however, embraced a different kind of therapy, which she attends in addition to her regular PT sessions. Once a week, Morgan heads to a local stable, where she mounts a horse called Moses and engages in exercises overseen by a licensed physical therapist. While on Moses, Morgan catches and tosses rings and balls and rides around in a circle.
And it's working. "Ever since Morgan started riding, she is standing more and walking better with her walker. It's also helped loosen her hips," Andrea says.
Hippotherapy—from the Greek word hippos, meaning "horse"—originated in ancient Greece as a form of exercise. Also known as equine therapy, therapists have been using horses to help patients of all ages achieve physical, occupational, developmental, and speech goals. Currently, more than 800 therapeutic riding centers exist in the United States, many of which are accredited by the American Hippotherapy Association.
Core Skills
Hippotherapy is not about learning to ride a horse, says Joann Benjamin, a physical therapist who has used hippotherapy for more than 30 years. "My patients almost never sit in a saddle or use reins, because we're not teaching them how to ride." Instead, therapists use the movement of the horse to engage specific muscles. For example, by trying to steady herself on Moses, Morgan gains core strength. Throwing a ball to the therapist while on Moses helps her improve her coordination and balance. When issuing commands to Moses, such as "go" or "stop," Morgan improves her oral motor control.
Unique Advantages
For children like Morgan who have cerebral palsy, sitting on a moving horse strengthens core, pelvic, and inner thigh muscles in ways that standard exercise machines cannot, says Carol Huegel, a physical therapist and current chair of the American Hippotherapy certification board. "With every step the horse takes, the person sitting astride the horse is having her pelvis moved exactly as though she were walking, in every plane of movement. We haven't been able to duplicate that anywhere else," says Huegel. "We can't move an exercise ball in all the planes that a horse moves."
Mood Boosts
In working with horses, riders may reap benefits beyond the physical. In a small 2015 study published in the Journal of Traumatic Stress, researchers found that equine-assisted therapy reduced riders' anxiety and helped them recover more quickly from a traumatic event. "Decreasing anxiety is not the primary aim of hippotherapy, but we've found that it's an added benefit," says Huegel.
Choose Wisely
People with allergies to dust and dander may experience a reaction to horses, and those with fragile bones or bleeding disorders are at an increased risk of injury if they fall off the horse. For this reason, therapists usually choose smaller horses with gentle dispositions. Medically fragile people should discuss the risks and benefits of hippotherapy with their physicians.
For Andrea Frazier, the choice is obvious. Morgan continues to gain strength, balance, and coordination from Moses—and she loves every minute of it.
Online Resources
For more information, visit americanhippotherapyassociation.org. To find a center near you, visit bit.ly/PATH-FindACenter.